Manor Care Mountainside - Mountainside Nursing Home
General Information
UPDATEFederal Provider Number
315259
Provider Name
MANOR CARE MOUNTAINSIDE
Provider Address
1180 ROUTE 22 WEST
MOUNTAINSIDE, NJ 7092
MOUNTAINSIDE, NJ 7092
Provider Phone Number
(908) 654-0020
Provider SSA County
370
Provider County Name
Union
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
151
Number of Residents in Certified Beds
144
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MANOR CARE OF MOUNTAINSIDE NJ LLC
Date First Approved to Provide Medicare and Medicaid services
1988-05-19
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.81424
Reported LPN Staffing Hours per Resident per Day
0.70243
Reported RN Staffing Hours per Resident per Day
1.02049
Reported Licensed Staffing Hours per Resident per Day
1.72292
Reported Total Nurse Staffing Hours per Resident per Day
3.53716
Reported Physical Therapist Staffing Hours per Resident Per Day
0.13646
Expected CNA Staffing Hours per Resident per Day
2.50325
Expected LPN Staffing Hours per Resident per Day
0.72521
Expected RN Staffing Hours per Resident per Day
1.16556
Expected Total Nurse Staffing Hours per Resident per Day
4.39403
Adjusted CNA Staffing Hours per Resident per Day
1.77833
Adjusted LPN Staffing Hours per Resident per Day
0.80393
Adjusted RN Staffing Hours per Resident per Day
0.65420
Adjusted Total Nurse Staffing Hours per Resident per Day
3.24484
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2015-03-18
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2014-04-08
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2013-01-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
35.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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